Day 175 - Lesson Recap

It is 25 weeks since the accident. Jan is driving and nearly back to normal but the last little bits of normal are the hardest to get back. She still has pains in her neck and shoulders and takes a fair bit more pain relievers than pre-accident. There are still several activities she has not rejoined, such as Jazzercise.

This whole ordeal has taught me several things that may be of value to others. I will try to relate them to you so that other people may learn from my mistakes. If just one person is spared the misery and suffering at the hands of the medical profession, it will have accomplished my goal.

1. If it is not a matter of life and death, get a second opinion
2. If it is an auto accident and there is PIP (personal injury protection) involved, let any other insurance pay first
3. You have a choice, don't be bullied
4. If you are given a nurse practitioner and don't feel comfortable, you can get the doctor scheduled instead
5. Do not let a resident perform complex procedures without an attending

Simple rules and I'll explain each of them in more detail and my thoughts for each. You will, hopefully, understand my reasoning for each and how it may affect you or a loved one in a medical emergency.

Beginning with the second opinion, this is what I think. In the case of Jan's injury, after the fact, we got a second opinion and that doctor said it might have been treated with just a brace. In the UK and other places, halos are rare. Had we had a discussion with a real doctor and not the resident just throwing the thing on her body and skull, things most certainly would have been different. If we had been part of the decision, I would have no room to complain.

Next, PIP insurance is to ensure that immediate medical care can be provided without worry of payment. It generally covers the first $10,000 per person. Jan burned through that in little under three hours. After that, the health insurance started paying and they slashed the originally billed amounts to slivers of the billed amount. If we had left the PIP out and let health insurance first reduce the bill, the PIP $10,000 would have more than covered all of the accident-related medical costs. It is also permissible to reimburse yourself for out of pocket costs first from the PIP money, which can be a lifesaver should there be extraordinary out of pocket expenses, such as travel, medications and other related expenses.

Choice is the cornerstone of a free society. After the halo was installed, Jan's choices dried up to none. Even though she was stuck with Bilkmore, she still had choices but they were not presented to us until it was nearly too late. She did not have to endure the repeated inefficiencies of the Bilkmore radiology department. She could have requested and if not honored then demanded that her radiology studies be done at a place more convenient for her. Convenience to the doctor or nurse is immaterial when the patient is being beaten down by the system. Patient comfort and ease is the primary concern of anyone that cares.

Nurse practitioners are usually very good and often spend more time with patients than doctors. However, if you feel you are not getting the attention and concern you deserve, as in Jan's two visits in 11 weeks, then you have the right to request a visit with the doctor instead. I only wish we had known this from the onset. We would have had no visits with that particular nurse. When she took 13 days to return our first call, I knew we were off to a bad start but did not know our rights.

Residents are not licensed doctors and as such are supposed to be supervised. They need to learn sometime and you learn by doing but there are certain things you do not want to be the guinea pig for when the inexperienced doctor is learning, especially when he is doing it alone without the necessary supervision. Jan's intern was not prepared, not experienced and certainly did not administer the halo properly. It is a team installation and he did it alone. When you are looking at 12 weeks in a halo, you want the person putting it on to be professional and to fit it as comfortably as possible.

There are other lessons learned from this but they are more personal. For one, I should have become more insistent that Jan's wishes be the highest priority from the beginning. Second, how and what I feel is not important if Jan isn't at least comfortable. Additionally, I can't do it all, no matter how hard I try. Finally, the medical establishment is about making money first and helping people if it is profitable.